Post-ablation syndrome after percutaneous cryoablation of small renal tumors: A prospective study of incidence, severity, duration, and effect on lifestyle.

To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation.

We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events.

The incidences of fever, nausea, vomiting, and malaise were 100% (40/40), 20% (8/40), 20% (8/40), and 63% (25/40), respectively. Most (78/81, 96%) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94%) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively.

All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.

European journal of radiology. 2019 Nov 13 [Epub ahead of print]

Takahiro Kawabata, Takao Hiraki, Toshihiro Iguchi, Yusuke Matsui, Mayu Uka, Yoshihisa Masaoka, Toshiyuki Komaki, Jun Sakurai, Hideo Gobara, Motoo Araki, Yasutomo Nasu, Susumu Kanazawa

Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan., Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan. Electronic address: ., Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan., Department of Medical Informatics, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan., Department of Urology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.